Diana Fosha Speaks on Healing Affects and Interactions in AEDP

Dr. Diana Fosha, one of the leading contributors to contemporary affect theory, addressed the process of change and its role in therapy at a packed Alumnae/i Association lecture at the Ackerman Institute on January 29.

Dr. Fosha said that while the development of psychotherapy has supported the creation of a lexicon to explain how things change for the worse (i.e., the theory of the development of psychopathology), there is far less understanding and less of a vocabulary to explain how change actually takes place, the process and specific mechanisms of change. To do so, she introduced the motivational construct of “transformance” as the counterpoint of resistance. She said that psychic processes, which operate under the umbrella of “transformance,” tend to be “progressive, expansive, energetic and fueled by hope.” Transformance-informed processes are always accompanied by positive affect, Dr. Fosha explained, although that does not necessarily mean happiness. She said that the positive affect that grows out of transformance is closer to a sense of peace or rightness.

Healing addresses the idea that people are not just “bundles of pathology,” but beings with innate, wired-in dispositions for self-healing, Dr. Fosha said. Because AEDP is healing oriented, rather than psychopathology-based, the therapy seeks to entrain adaptive affective change process in which the therapist and patient work together to harness the healing potential of change.

Attachment recognizes that people are wired to care, Dr. Fosha said. She explained that the AEDP therapist works to facilitate and co-construct a patient-therapist relationship characterized by secure attachment. This relationship is the secure base from which fear, shame and distress can be dyadically regulated.When operating optimally, she continued, dyadic affect regulation is a process that ultimately ensures that the patient in therapy is not alone with intense emotional experiences, but able to share them with a partner (the therapist), who can support, be there and help in the processing of these emotions to completion.

The overall goal of AEDP, Dr. Fosha said, is to facilitate a new healing experience that involves a transformation achieved through the moment-to-moment tracking of bodily-rooted emotional experience. The experiential method allows the patient to have an experience in which the body is involved and tracking moment-to-moment fluctuations is the emotional experience of the patient, therapist, and dyad.

Emotion or the visceral experience of core affects is the central agent of change in AEDP. Positive affects and positive affective interactions are both the constituents and the wired-in affective markers of healing transformational processes and adaptive experiences.

In the end, Dr. Fosha noted that focusing on, affirming, and experientially exploring the experience of transformation led to the discovery that the experiential exploration of transformation is, in itself, an affective change process.

Dr. Fosha used a 45-minuted tape of her work with a young female patient to illustrate many of her points. Although the session was short, it demonstrated clearly how Dr. Fosha, using the techniques she described earlier, was able to help her patient move from a very angry, emotionally withdrawn state to one in which she was able to access her feelings, let go of a good deal of her anger, and emerge in a place of calm, ease, self-acceptance and new understanding, almost a wisdom of sorts.

Dr. Fosha said that as a person processes transformation, another change process is launched. This processing of that which is therapeutic, or metatherapeutic processing, makes the implicit explicit and the explicit experiential. It leads ultimately, Dr. Fosha explained, to a core state of openness, compassion and self-compassion, and a sense of things feeling right.